Acta Oncologica最新文献

{"title":"Predictive factors of oral mucositis in patients with locally recurrent inoperable head and neck cancer treated with boron neutron capture therapy.","authors":"Tanja Mälkiä, Hanna Koivunoro, Tiina Seppälä, Leena Kankaanranta, Liisa Porra, Anu Anttonen, Mikko Tenhunen, Heikki Joensuu","doi":"10.2340/1651-226X.2025.44039","DOIUrl":"10.2340/1651-226X.2025.44039","url":null,"abstract":"<p><strong>Background and purpose: </strong>The prognosis of recurrent head and neck (HN) cancer is poor. High response rates have been achieved with boron neutron capture therapy (BNCT) in the treatment of locally recurrent HN cancer. Radiation-induced oral mucositis (OM) is a common adverse effect of BNCT. We evaluated the factors associated with severe OM in patients treated with BNCT. Patient/material and methods: Ninety two patients with locally recurrent inoperable HN cancer were treated with nuclear reactor-based BNCT in 1-2 fractions. The association between grade 3 OM, patient clinical parameters and maximum weighted oral mucosa dose was evaluated. Mucosal dose was calculated using the skin nitrogen concentration of 4.2%. A sigmoidal normal tissue complication probability (NTCP) model was created by dividing patients into four equal sized groups based on increasing dose levels.</p><p><strong>Results: </strong>Grade 3 OM was observed in 42% of patients after the first BNCT treatment. The prevalence of OM increased with higher maximum oral mucosa doses. From the NTCP curve, we estimated the dose corresponding to a 50% probability (D50) for grade 3 OM to be 13.5 Gy(W). Older age was the only patient- related factor significantly associated with increased grade 3 OM risk.</p><p><strong>Interpretation: </strong>Higher maximum oral mucosa doses increased the risk of grade 3 OM. Older age was the only other factor related to severe OM.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1307-1311"},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complete remission with olaparib in BRIP1-mutated metastatic high-grade pleomorphic sarcoma: case study and literature review - an example of a genomic profiling-based tumor treatment, in a cancer type with high unmet clinical need.","authors":"Alexander D J Thooft, Sofie Joris, Celine Jacobs, David Creytens, Sylvie Rottey, Brigitte Maes, Philippe Aftimos, Lore Lapeire","doi":"10.2340/1651-226X.2025.43374","DOIUrl":"10.2340/1651-226X.2025.43374","url":null,"abstract":"<p><strong>Background and purpose: </strong>Patients with high-grade metastatic sarcoma have a poor prognosis and limi-ted treatment options, mostly involving chemotherapy with palliative intent. In the past years, next generation sequencing has proven its benefit in cancer diagnostics and prediction of treatment response to targeted therapy. Patient/material and methods: We present a case of response and long-term complete remission under treatment with the poly(ADP-ribose) polymerase inhibitor (PARP-inhibitor) olaparib in a patient with meta-static high-grade pleomorphic sarcoma, with an next generation sequencing detected BRIP1-mutation. Additionally, a literature search regarding the pathophysiology of BRIP1-mutations and the role of PARP-inhibitors in BRIP1-mutated cancer was conducted.</p><p><strong>Results: </strong>A 67-year-old female patient was diagnosed with a high-grade intra-abdominal pleo-morphic sarcoma, which was surgically resected. One year later, metastatic lesions in the right lung were observed. Genomic profiling identified a BRIP1-mutation. Based on this finding, the patient was included in the PRECISION-2 olaparib study, which evaluates the efficacy of olaparib in advanced cancers of any type harboring mutations in a homologous recombination gene. Within 2 months of ola-parib treatment, regression of the pulmonary metastases was observed with ongoing complete remission for currently 36 months. A review of the available literature highlights the importance of BRIP1 in the homologous recombination repair pathway and its role as a cancer susceptibility gene. Studies in BRIP1-mutated breast cancer, ovarian cancer, and prostate cancer suggest a clinical benefit of PARP-inhibitor use.</p><p><strong>Interpretation: </strong>We here describe the first case of a metastatic BRIP1-mutated sarcoma, undergoing a complete radiologic response to olaparib treatment. We highlight an underexplored role of homologous recombination deficiency in non-traditional cancer types and postulate a tumor-agnostic approach to the use of PARP-inhibitors in BRIP1-mutated tumors.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1295-1306"},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric impact of esophageal motion in esophagus-sparing radiotherapy of spinal metastases.","authors":"Anna Mann Nielsen, Laura Ann Rechner, Sebastian Moretto Krog, Vanja Gram, Morten Hiul Suppli, Patrik Sibolt, Ivan Richter Vogelius, Claus P Behrens, Gitte Fredberg Persson","doi":"10.2340/1651-226X.2025.44033","DOIUrl":"10.2340/1651-226X.2025.44033","url":null,"abstract":"<p><strong>Background and purpose: </strong>The phase III trial (NCT05109819) investigates whether esophagus-sparing radiotherapy (RT) reduces dysphagia in patients with spinal metastases. This retrospective simulation study evaluates the dosimetric impact of inter-fractional esophageal motion in this setting. Patient/materials and methods: Patients receiving daily image-guided RT on high-quality cone beam computed tomography (CBCT)-equipped units between September 2023 and December 2024 were screened. Inclusion required five consecutive CBCTs with vertebrae T1-T10 in view and a visible esophagus. The esophagus was contoured on the planning CT (pCT) and five CBCTs. Standard and esophagus-sparing 25 Gy/5 fraction volumetric-modulated arc therapy plans were simulated for five thoracic targets. In esophagus-sparing plans, the esophageal D0.027cc was limited to 8 Gy equivalent dose in 2 Gy fractions (α/β = 3 Gy), consistent with the ESO-SPARE constraint. CBCT-based esophagus contours were rigidly transferred to the pCT after bony matching. Esophageal metrics (Mean, D0.027cc-D5cc, V8.5 Gy) were extracted from the original plan and compared across CBCT and pCT contours and between plan types. Inter-fraction motion was assessed using 95% Hausdorff Distance (HD). CBCT quality was evaluated in two patients (five targets) using Dice similarity coefficients and interobserver 95% HDs.</p><p><strong>Results: </strong>Twelve patients with 23 targets were simulated. Inter-fraction motion led to dose constraint violations in 20 of 23 plans, though only small esophageal volumes entered the high-dose region. Dice scores > 0.8 confirmed good esophageal visibility on CBCT. Most 95% HDs fell within interobserver variability, indicating motion was comparable to contouring uncertainty.</p><p><strong>Interpretation: </strong>Despite constraint violations, high-dose exposure was limited to small esophageal volumes, and overall sparing was preserved.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1276-1284"},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pembrolizumab as first-line treatment for recurrent or metastatic head and neck squamous cell carcinoma: a multi-institutional DAHANCA cohort study.","authors":"Sebastian Søby, Robin Prestwich, Niels Gyldenkerne, Christian Maare, Camilla K Lonkvist, Maria Andersen, Kinga Nowicka-Matus, Anita Gothelf, Trine Tramm, Kasper Toustrup, Simion Mihaela, Danny Ulahannan, Zsuzsanna Iyizoba-Ebozue, Jesper G Eriksen","doi":"10.2340/1651-226X.2025.44327","DOIUrl":"10.2340/1651-226X.2025.44327","url":null,"abstract":"<p><strong>Background and purpose: </strong>Pembrolizumab is frequently used for recurrent or metastatic head and neck squamous cell carcinoma (rmHNSCC) as first-line treatment. This study evaluates real-world effectiveness in a Danish and United Kingdom (UK) cohort. Patient/material and methods: Patients with confirmed rmHNSCC treated with pembrolizumab (2020-2024) as first-line palliative treatment were included consecutively. Data were collected from patient files at four Danish head and neck cancer centres (discovery cohort) and the Leeds Teaching Hospitals NHS Trust (comparison cohort). Primary endpoints were overall survival (OS) and progression-free survival (PFS).</p><p><strong>Results: </strong>In the discovery cohort (n = 228), a median OS of 10 months (95% [confidence interval [CI]: 10-12) and median PFS of 4 months (95% CI: 4-6) were found. Primary endpoints did not differ significantly between the discovery and comparison cohort. Baseline World Health Organization performance status appeared to negatively impact endpoints (hazard ratio: 1.4 [95% CI: 1.0-2.0]).</p><p><strong>Interpretation: </strong>In this real-world multi-centre study, pembrolizumab demonstrated efficacy equivalent to the registration studies in two independent cohorts.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1269-1275"},"PeriodicalIF":2.7,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of GTV-CTV margin and other predictors on radiation-induced dysphagia in head and neck cancer patients from DAHANCA group.","authors":"Sarah Wordenskjold Stougaard, Ruta Zukauskaite, Richard Röttger, Ebbe Laugaard Lorenzen, Maximilian Lukas Konrad, Simon Long Krogh, Camilla Panduro Nielsen, Jeanette Frieda Aviaya Sommer, Jørgen Johansen, Jesper Grau Eriksen, Camilla Kjaer Lonkvist, Jeppe Friborg, Carsten Brink, Christian Rønn Hansen","doi":"10.2340/1651-226X.2025.44021","DOIUrl":"10.2340/1651-226X.2025.44021","url":null,"abstract":"<p><strong>Background and purpose: </strong>This multicentre, retrospective study aimed to develop a predictive model for radiation-induced dysphagia in head and neck cancer patients, focusing on the role of gross tumour volume (GTV) to high dose CTV (CTV1) margin size and dose-related factors. Unlike previous studies focused on peak or single time-point dysphagia, this study modelled symptom trajectories using repeated follow-up data for a more complete picture. Patient/material and methods: Between 2010 and 2015, 1,948 patients with pharyngeal or laryngeal squamous cell carcinoma received definitive intensity-modulated radiotherapy (IMRT) at three Danish centres. Data included physician-rated dysphagia (grade 0-4), tumour and treatment characteristics, and AI-based segmentations of organs at risk (OARs). Predictors included GTV-CTV1 margin size, mean doses to the oral cavity and pharyngeal constrictor muscles (PCM), GTV volume, chemotherapy, tumour site, fractionation, nimorazole, sex, smoking status, baseline dysphagia, and age. A logistic ordinal mixed-effects model was fitted with patient ID as random effect. Data were split into training (70%) and test (30%) sets. Model performance was assessed using calibration plots and area under the curve (AUC).</p><p><strong>Results: </strong>After excluding incomplete cases, 1,685 patients (7,829 visits) were analysed. GTV-CTV1 margin size was not significantly associated with dysphagia, although larger margins correlated with higher OAR doses. Higher doses to the lower PCM (odds ratio [OR] = 1.30 per 5 Gy) and oral cavity (OR = 1.32 per 5 Gy) increased risk. The model demonstrated good calibration and robust discrimination (AUC = 0.77-0.84).</p><p><strong>Interpretation: </strong>Radiation dose to the oral cavity and lower PCM were the strongest modifiable predictors of dysphagia risk. Margin size was not independently associated, possibly due to confounding by clinical judgement.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1253-1261"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Balancing benefit and burden: treatment intensification in paediatric KMT2A rearrangements acute myeloid leukaemia.","authors":"Hend Fayez, Mariam Elsherif, Sherine Salem, Nahla Elsharkawy, Amr Elnashar, Mohamed Kamal, Reham Khedr, Leslie Lehmann, Sonia Ahmed, Alaa Elhaddad","doi":"10.2340/1651-226X.2025.43878","DOIUrl":"10.2340/1651-226X.2025.43878","url":null,"abstract":"<p><strong>Background and purpose: </strong>Chromosomal rearrangements involving KMT2A (KMT2A-r) occur in 20% of paediatric acute myeloid leukaemia (AML). Previous studies reported that the outcome depends on the specific fusion partner. The study aimed to report the outcomes of paediatric KMT2A-r AML patients and to assess the impact of different fusion partners. Patient/material and methods: We retrospectively analysed 610 paediatric patients with intermediate-risk (IR) AML diagnosed at Children's Cancer Hospital Egypt, from January 2008 to December 2021. Patients were assigned to four groups based on fusion partner.</p><p><strong>Results: </strong>Of 610 patients diagnosed with IR-AML, 150 (24.6%) had KMT2A rearrangements. KMT2A-r was significantly associated with hyperleukocytosis (P = 0.029), central nervous system (CNS) disease (P = 0.003), monocytic differentiation (P = 0.001), additional cytogenetic abnormalities (ACA) (P = 0.04), and complex karyotype (P = 0.001). Fusion partner, t(9;11) (p22;q23) (9p22/KMT2A::MLLT3 fusion) was most prevalent (40.8%). KMT2A-r was an independent predictor of relapse with a cumulative incidence of relapse (CIR) of 46% versus 30% in KMT2A negative group (P = 0.006). Within the KMT2A-r group, ACA and complex karyotype adversely affected the outcome with 5-year overall survival (OS) of 34% versus 53% (P = 0.027) and 26% versus 51% (P = 0.004), respectively. Outcome varied depending on fusion partner. Event-free survival (EFS) ranged from 50% to 17%, OS from 54% to 27%, and CIR from 75% to 38%.</p><p><strong>Interpretation: </strong>KMT2A-r is an independent prognostic factor for relapse, and presence of ACA and a complex karyotype in KMT2A-r patients is associated with poorer outcomes, emphasising the need for aggressive and innovative therapeutic strategies.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1227-1236"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of radiation dose on neurocognitive function and quality of life in long-term survivors of childhood brain tumour.","authors":"Laura Toussaint, Anne Sophie Lind Helligsø, Ludvig Paul Muren, Ali Amidi, Rikke Hedegaard Dahlrot, Louise Tram Henriksen, Maja Vestmø Maraldo, Martin Skovmos Nielsen, Anouk Kirsten Trip, Lisa Maria Wu, Yasmin Lassen-Ramshad","doi":"10.2340/1651-226X.2025.43989","DOIUrl":"10.2340/1651-226X.2025.43989","url":null,"abstract":"<p><strong>Background and purpose: </strong>Children treated with radiotherapy (RT) for a brain tumour often exhibit neurocognitive impairment and report lower quality of life (QoL) later in life. The aim of this nationwide cross-sectional cohort study was to explore the impact of RT dose to brain organs at risk (OARs) on neurocognition and QoL in long-term survivors of childhood brain tumours. Patient/material and methods: A total of 132 survivors of childhood brain tumours, diagnosed from 2001 to 2017 in Denmark, underwent neurocognitive tests and QoL questionnaires at least 5-years post-diagnosis. Neurocognitive assessments were complete and available for 86 patients (61 no-RT/25 RT), and QoL scores for 107 (79 no-RT/28 RT). Mann Whitney U-tests were used to compare scores between no-RT and RT groups. For scores impacted by RT, OAR-specific robust linear regressions were performed to evaluate RT dose effects while adjusting for potential confounders.</p><p><strong>Results: </strong>Clinically significant overall cognitive impairment was observed for 55% of the neurocognitive sub-cohort, with younger age at treatment time as a significant risk factor, while hydrocephalus status had no impact. There were no statistically significant differences on neurocognitive tests between the RT and no-RT group. However, patients treated with RT had significantly lower scores on the physical and social functioning QoL domains, with mean dose to the pituitary gland and left hippocampus, respectively, as significant predictors.</p><p><strong>Interpretation: </strong>This cross-sectional study indicates that RT dose-effects, particularly in the pituitary gland and left hippocampus, might contribute to reduced QoL in survivors of childhood brain tumours.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1245-1252"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late dysphagia after changes in high-dose clinical tumour volume margin for head and neck cancer patients.","authors":"Ruta Zukauskaite, Jesper Grau Eriksen, Jørgen Johansen, Eva Samsøe, Morten Horsholt Kristensen, Lars Johnsen, Camilla Kjaer Lonkvist, Cai Grau, Jens Overgaard, Christian Rønn Hansen","doi":"10.2340/1651-226X.2025.43924","DOIUrl":"10.2340/1651-226X.2025.43924","url":null,"abstract":"<p><strong>Background and purpose: </strong>One of the factors influencing disease control and toxicity risk after radiotherapy is selection of treatment volume margin. This study evaluates whether different gross tumour volume (GTV) to high-dose clinical target volume (CTV1) margins impact dysphagia in a cohort of head and neck squamous cell carcinoma (SCC) patients. Patient/material and methods: Data of patients receiving primary IMRT-based radiotherapy for SCC for the oropharynx, hypopharynx, and larynx at three treatment centres between 2010 and 2015 were retrospectively collected. Treatment planning followed two DAHANCA guideline periods: pre-2013 (varying GTV-CTV1 margins), and post-2013 (isotropic 5 mm margin). Treatment plans were collected for 1,913 patients. GTV-CTV1 margins were calculated as median surface distance from GTV to CTV1. Dysphagia was graded using modified DAHANCA ordinal scale. For each patient, the highest score of dysphagia during 5-year follow-up period was chosen for analysis.</p><p><strong>Results: </strong>Dysphagia data were available for 1,706 patients (89%). The median GTV-CTV1 margin was 9.0 mm in 2010-2012 and 4.7 mm in 2013-2015. The severity of dysphagia was more pronounced in patients treated during 2010-2012 (p = 0.003). Predictors of grade ≥ 2 dysphagia included larger GTV (odds ratio [OR]: 1.7; p < 0.001), larger GTV-CTV1 margin (odds ratio [OR] of 1.3 per cm; p = 0.04), and tumour localisation other than oropharyngeal p16+carcinomas (p = 0.002). Male sex, non/previous smoking status, and application of chemotherapy were associated with less severe dysphagia.</p><p><strong>Interpretation: </strong>Tumour volume and GTV-CTV1 margin are dominant geometric parameters influencing dysphagia risk following curative radiotherapy.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1262-1268"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12459203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145084964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic position and employment status in patients with lung cancer - a register-based study.","authors":"Emma Brink, Marc Sampedro Pilegaard, Claus Vinther Nielsen, Pernille Pedersen","doi":"10.2340/1651-226X.2025.44017","DOIUrl":"10.2340/1651-226X.2025.44017","url":null,"abstract":"<p><strong>Background and purpose: </strong>Lung cancer patients have an increased risk of adverse employment outcomes. However, limited research exists on the association between socioeconomic position (SEP) and employment status in this cancer group. This study explored the influence of SEP on employment status after a lung cancer diagnosis. Patient/material and methods: This population-based cohort study included all working-age Danish residents diagnosed with lung cancer between 2000 and 2015. Logistic regression analyses were conducted to assess the association between socioeconomic variables (education, income, sick leave, and work status before diagnosis), and working and disability pension 3 years after diagnosis.</p><p><strong>Results: </strong>A total of 1,946 lung cancer patients were included. High income and long education were associated with higher odds of working, odds ratio (OR) = 2.31 (1.65-3.24) and OR = 1.92 (1.15-3.21), respectively, and lower odds of disability pension, OR = 0.19 (0.11-0.33) and OR = 0.30 (0.13-0.70), respectively. Moreover, sick leave and being out of work before diagnosis were associated with lower odds of working, OR = 0.25 (0.13-0.46) and OR = 0.32 (0.24-0.43), respectively, and higher odds of disability pension, OR = 3.73 (2.14-6.50) and OR = 2.88 (2.14-3.87), respectively.</p><p><strong>Interpretation: </strong>Lung cancer patients with low SEP are less likely to be employed and more likely to receive disability benefits. Therefore, rehabilitation to support socioeconomically disadvantaged lung cancer patients is needed.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1237-1244"},"PeriodicalIF":2.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of acute and late diarrhea in the treatment of anal cancer with concurrent chemoradiotherapy.","authors":"Katrine Smedegaard Storm, Karen-Lise Garm Spindler, Gitte Fredberg Persson, Claus Behrens, Patrik Sibolt, Sif Homburg, Sofia Spampinato, Camilla Kronborg, Eva Serup-Hansen","doi":"10.2340/1651-226X.2025.43975","DOIUrl":"10.2340/1651-226X.2025.43975","url":null,"abstract":"<p><strong>Background and purpose: </strong>Treatment-related diarrhea is a challenge for patients treated with chemo-radiotherapy (CRT) for anal cancer in a curative setting. This study aims to investigate dosimetric and clinical predictors of acute and late diarrhea for patients treated with CRT or radiotherapy (RT) alone for anal cancer. Additionally, to investigate different bowel contouring methods ability to predict diarrhea. Patient/material and methods: Patients treated with CRT or RT alone in the prospective, observational DACG-I Plan-A study (2015-2021) were included. Toxicity endpoints were acute grade ≥2 diarrhea, and late grade ≥1 diarrhea recorded at 1 year after treatment (Common Terminology Criteria of Adverse Events (CTCAE), v4.0). Bowel volumes were contoured on the planning computed tomography (CT) as bowel cavity, bowel bag, individual bowel loops, and terminal ileum. Dosimetric variables included V15Gy, V30Gy, and V45Gy for the different bowel volumes. Clinical variables included tumor size, N-stage, and chemotherapy regimen. Logistic regression was used to evaluate the association between variables and toxicity.</p><p><strong>Results: </strong>Of the 290 patients included in this study, 116 (40%) experienced acute grade ≥2 diarrhea, and 56 of 256 (22%) had late grade ≥1 diarrhea. Patients treated with 5-FU/Capecitabine had a threefold higher risk of acute diarrhea compared to those receiving weekly Cisplatin or RT alone (p < 0.001). A trend indicating an increased risk of acute grade ≥2 diarrhea for patients with larger bowel volumes receiving radiation was observed. This was most pronounced for bowel bag V30Gy (p = 0.09); however, results from the different bowel contouring methods were similar. No parameters were predictive of late diarrhea.</p><p><strong>Interpretation: </strong>No dosimetric or clinical predictors of late diarrhea were found and only a trend was found between higher dose to bowel and risk of acute diarrhea. Treatment with 5-FU/Capecitabine showed a notable association with acute diarrhea. No contouring method was superior in predicting diarrhea.</p>","PeriodicalId":7110,"journal":{"name":"Acta Oncologica","volume":"64 ","pages":"1217-1226"},"PeriodicalIF":2.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}